Individual provider Active NPI

Erica R Shah, O.D.

  • Optometrist
  • Marietta, GA
National Provider Identifier
1518067925
Registry record updated Oct 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV006985 Issued in NY
Practice address
3775 Roswell Rd Ste 150
Marietta, GA 30062-8821
Phone
(678) 321-2020
NPI assigned
Sep 25, 2006
Last updated
Oct 17, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TUV006985 NY Primary

Addresses

Primary practice location

3775 Roswell Rd Ste 150
Marietta, GA 30062-8821

Mailing address

3775 Roswell Rd Ste 150
Marietta, GA 30062-8821
Phone (678) 321-2020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TUV006985NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Briggs Vision Group, P.C. Optometrist Past Accepting new patients
State of New York Comptrollers Office Optometrist Past Accepting new patients
Saltzman, Tanis, Pittell, Levin and Jacobson PastSince Oct 9, 2017 Accepting new patients
State of New York Comptrollers Office Past Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508198400000",
    "number": "1518067925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3775 ROSWELL RD STE 150",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300628821",
            "telephone_number": "678-321-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3775 ROSWELL RD STE 150",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300628821",
            "telephone_number": "678-321-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "ERICA",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-25",
        "last_updated": "2017-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV006985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.